Different Gastric Tubes in Esophageal Reconstruction During Esophagectomy

Overview

Journal Esophagus

Publisher Springer

Specialties Gastroenterology
Oncology

Date 2023 Jul 25

PMID 37490217

Authors

Shaowu Sun

Zhulin Wang

Chunyao Huang

Kaiyuan Li

Xu Liu

Wenbo Fan

GuoQing Zhang

Xiangnan Li

Affiliations

Soon will be listed here.

Abstract

Esophagectomy is currently the mainstay of treatment for resectable esophageal carcinoma. Gastric grafts are the first substitutes in esophageal reconstruction. According to the different tailoring methods applied to the stomach, gastric grafts can be classified as whole stomach, subtotal stomach and gastric tube. Gastric-tube placement has been proven to be the preferred method, with advantages in terms of postoperative complications and long-term survival. In recent years, several novel methods involving special-shaped gastric tubes have been proposed, which have further decreased the incidence of perioperative complications. This article will review the progress and clinical application status of different types of gastric grafts from the perspectives of preparation methods, studies of anatomy and perioperative outcomes, existing problems and future outlook.

References

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Ladak F, Dang J, Switzer N, Mocanu V, Tian C, Birch D . Indocyanine green for the prevention of anastomotic leaks following esophagectomy: a meta-analysis. Surg Endosc. 2018; 33(2):384-394. DOI: 10.1007/s00464-018-6503-7. View

May I, SAMSON P . Esophageal reconstruction and replacements. Ann Thorac Surg. 1969; 7(3):249-77. DOI: 10.1016/s0003-4975(10)66183-8. View

Haverkamp L, Seesing M, Ruurda J, Boone J, V Hillegersberg R . Worldwide trends in surgical techniques in the treatment of esophageal and gastroesophageal junction cancer. Dis Esophagus. 2016; 30(1):1-7. DOI: 10.1111/dote.12480. View

Akiyama H, Miyazono H, Tsurumaru M, Hashimoto C, Kawamura T . Use of the stomach as an esophageal substitute. Ann Surg. 1978; 188(5):606-10. PMC: 1396768. DOI: 10.1097/00000658-197811000-00004. View

Shirakawa Y, Noma K, Maeda N, Ninomiya T, Tanabe S, Kikuchi S . Clinical characteristics and management of gastric tube cancer after esophagectomy. Esophagus. 2018; 15(3):180-189. DOI: 10.1007/s10388-018-0611-2. View

Meier R, Siewert J . Vascular anatomy of the gastric tube used for esophageal reconstruction. Ann Thorac Surg. 1992; 54(6):1110-5. DOI: 10.1016/0003-4975(92)90077-h. View

Tabira Y, Sakaguchi T, Kuhara H, Teshima K, Tanaka M, Kawasuji M . The width of a gastric tube has no impact on outcome after esophagectomy. Am J Surg. 2004; 187(3):417-21. DOI: 10.1016/j.amjsurg.2003.12.008. View

Sugimachi K, Ikeda M, Kai H, Ueo H, Okudaira Y, Inokuchi K . Assessment of the blood flow in various gastric tubes for esophageal substitutes. J Surg Res. 1982; 33(6):463-8. DOI: 10.1016/0022-4804(82)90063-4. View

10.

Ndoye J, Dia A, Ndiaye A, Fall B, Diop M, Ndiaye A . Arteriography of three models of gastric oesophagoplasty: the whole stomach, a wide gastric tube and a narrow gastric tube. Surg Radiol Anat. 2006; 28(5):429-37. DOI: 10.1007/s00276-006-0129-5. View

11.

Pierie J, de Graaf P, van Vroonhoven T, Obertop H . The vascularization of a gastric tube as a substitute for the esophagus is affected by its diameter. Dis Esophagus. 1999; 11(4):231-5. DOI: 10.1093/dote/11.4.231. View

12.

Hong Z, Huang L, Zhang W, Kang M . Indocyanine Green Fluorescence Using in Conduit Reconstruction for Patients With Esophageal Cancer to Improve Short-Term Clinical Outcome: A Meta-Analysis. Front Oncol. 2022; 12:847510. PMC: 9198426. DOI: 10.3389/fonc.2022.847510. View

13.

Ryan C, Paniccia A, Meguid R, McCarter M . Transthoracic Anastomotic Leak After Esophagectomy: Current Trends. Ann Surg Oncol. 2016; 24(1):281-290. DOI: 10.1245/s10434-016-5417-7. View

14.

Ishige F, Nabeya Y, Hoshino I, Takayama W, Chiba S, Arimitsu H . Quantitative Assessment of the Blood Perfusion of the Gastric Conduit by Indocyanine Green Imaging. J Surg Res. 2018; 234:303-310. DOI: 10.1016/j.jss.2018.08.056. View

15.

Zhang M, Li Q, Tie H, Jiang Y, Wu Q . Methods of reconstruction after esophagectomy on long-term health-related quality of life: a prospective, randomized study of 5-year follow-up. Med Oncol. 2015; 32(4):122. DOI: 10.1007/s12032-015-0568-0. View

16.

Shu Y, Sun C, Shi W, Shi H, Lu S, Wang K . Tubular stomach or whole stomach for esophagectomy through cervico-thoraco-abdominal approach: a comparative clinical study on anastomotic leakage. Ir J Med Sci. 2013; 182(3):477-80. DOI: 10.1007/s11845-013-0917-y. View

17.

Zhang W, Yu D, Peng J, Xu J, Wei Y . Gastric-tube versus whole-stomach esophagectomy for esophageal cancer: A systematic review and meta-analysis. PLoS One. 2017; 12(3):e0173416. PMC: 5340360. DOI: 10.1371/journal.pone.0173416. View

18.

Yoshida K, Tanaka Y, Imai T, Sato Y, Hatanaka Y, Suetsugu T . Subtotal stomach in esophageal reconstruction surgery achieves an anastomotic leakage rate of less than 1%. Ann Gastroenterol Surg. 2020; 4(4):422-432. PMC: 7382430. DOI: 10.1002/ags3.12336. View

19.

Li X, Hua T, Zhang C, Xu Y, Wu W, Zheng C . The ratio of gastric tube length to thorax length: a vital factor affecting leak after esophageal cervical anastomosis. Ann Transl Med. 2021; 9(6):458. PMC: 8039640. DOI: 10.21037/atm-20-6082. View

20.

Markar S, Arya S, Karthikesalingam A, Hanna G . Technical factors that affect anastomotic integrity following esophagectomy: systematic review and meta-analysis. Ann Surg Oncol. 2013; 20(13):4274-81. DOI: 10.1245/s10434-013-3189-x. View